During Lame-Duck Session, ACP's Advocacy in Congress Continues

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Priorities during this period include legislation on physician payment changes and a COVID-19 stimulus relief package

Nov. 20, 2020 (ACP) – While the nation focuses on the new leader heading for the White House, the American College of Physicians is making sure to advocate for important legislation during the lame-duck session of Congress that lasts until the end of this year.

“This period is crucial for ACP advocacy,” said Rich Trachtman, ACP director of legislative affairs. “We'll continue to speak up about issues that are extremely important to physicians and their patients.”

On one front, ACP is concerned about fallout that may result from the prospect of cuts to physician payments for procedures. These cuts are scheduled to be implemented on Jan. 1 along with needed increases in evaluation and management services.

“ACP and its allies are in full support of the implementation of increased payments for outpatient evaluation and management services, implementation of a new billing code (known as the GPC1X code), which would provide increased payment for the complex care inherent to some office visit codes, higher payments for vaccine administration and other improvements in the 2021 proposed and previously finalized Medicare Physician Fee Schedule,” Trachtman said. “Given our strong support for the fee schedule changes that would be brought about by this rulemaking, ACP believes that Congress should urge the Centers for Medicare & Medicaid Services to move forward with the fee schedule changes and, above all, not take any legislative action that would delay or halt implementation of these important improvements.”

However, a requirement known as “budget neutrality” – which means that increases in payments in one area must be balanced by cuts elsewhere – could lead to reduced physician payments for certain services. ACP continues to express concern to Congress about the effects of some of the approaches that have been advanced to address the cuts. The College has activated its grassroots Advocates for Internal Medicine network to lobby legislators on these issues as they are likely to have a significant impact on the Medicare physician fee schedule.

“Many stakeholders have been appealing to lawmakers to take action in order to avoid these cuts in payments for services to Medicare beneficiaries,” Trachtman said. “ACP and our allies are working to ensure that any action taken by Congress to address these cuts for some services resulting from budget neutrality is fair to all services and specialties. Congress must not distort relative values and actual payments as determined through the usual regulatory process with public comments and input from physicians. And it must not disadvantage primary and comprehensive care services compared to other services. ACP also believes that Congress should avoid a temporary legislative fix that would create a future funding cliff.”

ACP is also opposing the Holding Providers Harmless From Medicare Cuts During COVID-19 Act of 2020. “While we are strongly supportive of providing relief to physicians who are adversely affected by revenue losses associated with COVID-19,” ACP wrote in a letter to members of Congress, “we must oppose the bill as introduced because it expressly lists as excluded services from hold harmless provisions the majority of office visits of primary and comprehensive care physicians, as well as the GPC1X add-on code that will be used for complex and prolonged office visits. In our view, it is wrong to exclude primary and comprehensive care physicians who are on the frontlines of treating COVID-19 patients, and the millions more patients they are treating for other medical conditions, from COVID-19 relief.”

On other fronts, ACP continues to lobby for a COVID-19 stimulus relief package. ACP hopes Congress and the president will work together to avoid a government shutdown, a dire prospect that could come on Dec. 11 if they fail to reach agreement on an extension of funding.

“Programs of interest to ACP members that hang in the balance include telehealth, electronic health information, gun violence prevention research, family planning and breast cancer screening,” Trachtman said. “We will continue to make sure our voice is heard, and we'll continue to speak up on behalf of physicians and patients.”

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